Aims To compare the diurnal intraocular pressure (IOP) efficacy and safety of timolol vs latanoprost in subjects with exfoliation glaucoma (XFG). Methods A 3-month prospective, singlemasked, active-controlled, parallel comparison performed in six centres in Greece that randomized subjects in a 1 : 1 ratio to either latanoprost in the evening (2000 hours) and placebo in the morning (0800 hours), or timolol twice daily (0800 and 2000 hours).Results In all, 103 subjects completed the study. After 3 months of chronic dosing, the latanoprost group exhibited a trend to a greater diurnal IOP reduction from an untreated baseline (24.973.2-17.472.9) compared with timolol (24.772.8-18.371.9 mmHg) (P ¼ 0.07). Latanoprost showed a significantly greater IOP reduction at 0800 hours (À8.5 vs À6.0 mm Hg for timolol, Po0.0001) whereas no difference was observed between the two medications at 1000, 1400, and 2000 hours after a Bonferroni Correction. In addition, latanoprost demonstrated a narrower range of diurnal IOP (2.4) than timolol (3.2 mmHg)(P ¼ 0.0017). Safety was similar between groups, except there was more conjunctival hyperaemia with latanoprost (n ¼ 8) than timolol (n ¼ 1)(P ¼ 0.01). Conclusions This study suggests that latanoprost provides a statistically lower 08:00-hour IOP and better range of IOP than timolol in the treatment of XFG glaucoma.
ABSTRACT.Purpose: To provide evidence for the hypothesis that dynamic iridolenticular contact predisposes to the development of glaucoma in exfoliation syndrome (XFS). Methods: We present four patients with bilateral XFS and unilateral exfoliation glaucoma (XFG) whose normotensive eyes had suffered traumatic loss of dynamic iridolenticular contact. Results: All 4 patients had bilateral XFS and developed XFG only in the untraumatized eyes. One patient had loss of iridolenticular contact in the traumatized eye, two had a nonreactive pupil, and one had had intracapsular cataract extraction at age 28. Conclusions: Loss of dynamic iridolenticular contact may help to protect against development of glaucoma in eyes with XFS.
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